Summary: Carol’s on an EMT run with Shep and Riley, so we can see more of Shep’s declining stability. Yay! Doug has landed in bed with Karen, and it takes Doug, like, five minutes to realize that he spent the night with his father’s girlfriend, or whatever she is to him. Neither of them is that disturbed by it, though.

Carol and the paramedics are called to a basement where a water heater has exploded. A little girl is trapped under some debris. Riley’s flustered, so Carol does his job for him and revives the girl. She objects when Shep tells the girls’ parents they can’t ride to the hospital with her. He thinks they’re drunks, and since they were dumb enough to let their daughter sleep near an unstable heater, they…don’t deserve to stay with her and try to keep her from being scared, I guess.

Susan was supposed to have the day off, but she’s at work, pretending that giving up Susie isn’t affecting her. She imagines herself searching her apartment while Susie cries. Weaver thanks her for filling in on short notice, promising she’ll be able to go home in a few hours. Susan says she can stay for a full 12-hour shift.

Morgenstern summons Mark and Weaver for what they think is an announcement of who won resident of the year. He promises that he submitted her name. Carter wants to assist on a breast reconstruction; Benton doesn’t really care. He thinks plastic surgery is a dumb specialty. The paramedics bring in the girl from the basement, and Doug and Benton will be working on her together, trying to ignore the tension between them.

Susan stitches up a blind woman who was mugged. Thanks to a self-defense course, the use of her cane as a weapon, and some sharp teeth, the woman not only got away with minor injuries, she also bit off the tip of the mugger’s pinky. She’d like to keep it as a souvenir. The girl from the basement, Becky, isn’t badly injured, and Shep credits Carol with taking good care of her. Benton finds a hernia and sends Becky to surgery.

Morgenstern wants to talk to Mark and Weaver about who should be chief resident next year. Mark nominates Susan, but Weaver isn’t sure she has all the qualities they want in a chief. Morgenstern agrees with her that they shouldn’t jump to any decisions. Hicks tells Carter that he hasn’t seen enough pediatric patients to graduate, so he’ll need to work with Doug for the next four weeks instead of assisting in plastics cases.

Connie brings her baby to visit, which makes Susan feel awkward. She thinks about her apartment search again. Lydia and Haleh enlist her to help them with a woman named Joanne who passed out in a crosswalk. She’s pregnant and is worried that she’s suffering another miscarriage. Susan thinks Joanne’s dizziness and high blood pressure are a result of her pregnancy, but Joanne says she’s had dizziness in between pregnancies. Susan decides she needs an ultrasound before she’s sent to OB.

Mark and Weaver go in to check on the case, since OB is upset that Susan hasn’t turned Joanne over to them yet. Weaver urges Susan to let her go already, sure that Joanne has preeclampsia. But Susan has correctly guessed that Joanne has a mass that’s causing her health problems and will need surgery. Fortunately, the baby should be fine. Mark congratulates Susan for the catch, though Weaver thinks OB would have figured it out.

Shep complains to Carol that Riley is a weak partner. He’s mad that Raul died trying to help lost causes in their fair city. Mark tells Randi that he and Jen are trying to work with a mediator to sort out their divorce. Randi says she doesn’t believe in divorce (but she doesn’t believe in marriage either). As an ailing Loretta comes in, Doug watches Days of Our Lives in the lounge with Lily and Haleh. He assures Carter that working in pediatrics won’t be too demanding for him.

A woman brings in her father, Mr. Dellanova, who has heart problems and is feeling sick. Susan almost immediately realizes that he took too much digitalis. This time, Weaver lets her take control, trusting that Susan knows what she’s doing. Benton chats with a Dr. Bradley, who wonders why Benton took almost three months to file a report about Vucelich’s fraud. He gives back the report, since Vucelich has added an addendum to his study listing all the data Benton thought he’d left out. Vucelich now claims that he always intended to include it.

Mark treats Loretta for dehydration connected to her chemotherapy. He’s annoyed that her doctor isn’t paying enough attention to her concerns, which include radiation burns that another patient said she shouldn’t have. Weaver wants Susan to present Mr. Dellanova’s case to some med students, but Susan doesn’t see the point. Weaver tries to get Mark to back her up and convince Susan to think more like a teacher. As they discuss her, Susan has trouble concentrating and flashes back to her apartment search again.

Doug gets a message from Karen, so Mark teases him a little. Doug says they have a “mutual acquaintance.” As Mark is about to go track down Loretta’s doctor and yell at him for sucking so badly, Jen shows up in hopes of working out their divorce settlement without their lawyers.

Carol and the paramedics go to an apartment building to tend to a teenager who was shot. One of his friends calls Carol a whore, so Shep grabs him by the neck. The victim is in bad shape, and as Shep tries to work on him, the boy’s brother keeps getting in the way. Shep eventually shoves him out of the way, but the boy hits his head on a coffee table and knocks himself out. Shep doesn’t care.

Carter thinks his patient just has the flu, but Doug thinks a seven-day fever of unknown origin is more than that. He diagnoses Kawasaki’s, and it’s a good thing he reviewed the case, because missing that could have been fatal. I’m thinking Carter isn’t as good to go on graduation as he thinks he is.

Susan stabilizes Mr. Dellanova, then tells his daughter that she’s surprised he took the wrong dosage, since it was right in the bottle. He doesn’t need glasses, but he also has trouble reading the paperwork he’s supposed to sign. Susan guesses correctly that he’s unable to read and has always hidden it from his daughter. She thinks he should tell her and let her help him. Mr. Dellanova asks if Susan has children, so of course she flashes back to her search again. We get it, show!

The paramedics bring in the brothers and Doug sticks around to tend to one, which means Karen has to wait to go to lunch with him. She goes to watch him in action, because apparently you can just wander around County without anyone caring. Doug and Benton work on the shooting victim while Carter, Carol, Weaver, and Harper work on the brother. Shep admits to pushing him, but Riley thinks he’s downplaying the seriousness of the situation. Shep tells him off for not keeping his mouth shut.

Doug’s finally ready for lunch, but seeing all the blood in the ER has made Karen lose her appetite. She’s concerned that she can’t reach Ray, who’s supposedly in the Cayman Islands with some of her money. But who cares, when she has his son? Mark finally finds Loretta’s doctor, Howard, who clearly doesn’t care about the side effects she’s suffering or the fact that she’s overwhelmed with her condition and treatments. I think he’s confused that Mark cares about a patient so much.

Carter tricks Benton into attending a surprise party in a trauma room – he’s been named resident of the year. Weaver tells Mark that Susan showed all the qualities they want in a chief resident today; she just wishes Susan would be like this all the time. As he’s leaving for the night, Doug maturely congratulates Benton for his honor. Hicks tells Benton that Vucelich seems to have nominated him for the award.

Carter says goodbye to Harper, who’s going…somewhere. Who cares? She’s leaving the show. Shep complains to Carol that Riley’s filing an incident report about his violent behavior. He wants Carol to agree with him that he didn’t do anything that bad. While Mark and Jen work out some custody arrangements without any complications, Susan treats a man named Mr. Johnston who claims he accidentally cut off the tip of his pinky while making a sandwich. He also has a testicular injury courtesy of a cane. Susan and Haleh strap him to a gurney while they call the police.

Mark and Jen…oh, freaking A. Mark and Jen just had sex. She doesn’t know what to tell her new boyfriend, Craig. Mark points out that she’s had to confess to infidelity before. Jen thinks he only slept with her as an act of revenge. In other ill-advised-couple news, Doug and Karen go to a nightclub together.

Susan goes home to her empty apartment and reminisces about when it wasn’t so empty. Then we learn why she’s really been so distressed: Chloe and Joe have taken Susie and moved across the country. When they were leaving, Susan ran up to her apartment to look for one of Susie’s toys while Susie cried in the car. Susan got so worked up that she started crying, too. Chloe found the toy, and Susan realized that she has to let the baby go for good.

Thoughts: Joanne is played by Romy Rosemont. She was also in a Grey’s Anatomy episode with Scott Michael Campbell (Riley). And she’s married to StephenRoot! I had no idea!

Carter treats a little boy, and when he tells the kid to take a deep breath, the kid takes the hugest, most overexaggerated breath ever. I love it.

Sleeping with you doesn’t get revenge on you, Jen. It only punishes Mark. Also, on another show, this probably would have led to a pregnancy and a paternity mystery, so thank God this doesn’t go there.